Reports directly to the Director of Therapy and is responsible for the care coordination of the clinical population and Clinical Case Managers. Responsible for admissions and recertification assessments, including supporting documentation, as assigned. Ensures compliance with MGA, Department of Health Service policies and procedures, and policies of accrediting agencies. Responsible for maintaining compliance with all reimbursement guidelines. Participates in program development and implementation. Duties and ResponsibilitiesUnder the direction of the Director of Therapy - plans, organizes, and manages the provision of patient care and Clinical Case Managers. Acts as a first-line manager for designated staff and assists with patient care as needed. Day-to-day management of provider issues and care delivery. Contributes to improving quality and consistency of patient care & experience. Evaluates quality of care, patient satisfaction, and compliance. Facilitates Care Coordination Meetings and provides leadership in problem-solving and gives professional advice from a clinical perspective. Reviews, implements, and interprets clinical policies and procedures as directed by DOT. Serves as a clinical lead at relevant clinical and departmental meetings. Enforces and demonstrates compliance with all State and Federal regulations. Communication with case managers (State-funded programs, Medicaid, and third-party payors), clinical updates, and ensuring continuing authorizations and re-verification of eligibility. Compliance and participation in the continuing quality improvement and utilization review of organizational services. Supports and executes the mission, ethics, and goals of the company effectively. Represents themselves in a positive and professional manner in the company and community.Adheres to dress code with a clean and neat professional appearance.Reports on time and as scheduled in order to complete work within designated time.Adhere to all company policies and procedures outlined in Employee Handbook, Employee Agreement, or communicated from executive team.Maintain a steady patient caseload. Interview and screen candidates. Aid in terminations, coaching, education, and counseling of field staff. Assist in the management of complaint intakes, track, and follow-up. Meet and greet potential new cases. Participates in QAPI/PAC as appropriate. Assist with QA audits as needed/when appropriate. Takes an active role during in-service meetings to promote team re-education and compliance. Other duties as assigned. 
